Document Detail

Endovascular treatment of acute and subacute hemorrhage in the head and neck.
MedLine Citation:
PMID:  11031414     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Acute and subacute hemorrhage in the head and neck often represent a life-threatening situation. The goal of this study is to evaluate the indications for and contributions of endovascular techniques in the diagnosis and management of such severe cases. DESIGN: Seventy-two patients with acute or subacute intractable hemorrhage of the head and neck were treated over a period of 5 years: 2 patients had experienced trauma; in 6 cases the cause of bleeding was iatrogenic; and in 2 patients intraosseous arteriovenous malformations were manifested. Fifteen patients had tumors, 9 of whom had prior radiotherapy. Forty-seven patients presented with epistaxis (41 idiopathic and 6 during anticoagulation therapy). The endovascular therapy was performed using polyvinyl alcohol particles, fibered platinum or electrolytically detachable coils (Guglielmi detachable coils; Target Therapeutics, Fremont, Calif), a stent, glue (Ethibloc; Ethicon GmbH, Norderstedt, Germany, and Histoacryl; B. Braun Melsungen AG, Melsungen, Germany), or with a combination of these different embolic materials. RESULTS: The acute bleeding was successfully controlled in all cases. Fourteen patients (7 with epistaxis, 5 with tumors, and 2 with arteriovenous malformations) had to be embolized more than once before the bleeding could be controlled. The idiopathic, traumatic, iatrogenic, and remaining tumoral cases were treated only once. The long-term morbidity was 1.9%. CONCLUSIONS: Owing to the recent continuous advances in interventional radiologic techniques, it is possible to treat both acute and subacute life-threatening head and neck hemorrhage most efficiently. In many cases the endovascular therapy complements surgery.
L Remonda; G Schroth; M Caversaccio; K Lädrach; K O Lövblad; P Zbären; J Raveh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  126     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-30     Completed Date:  2000-10-30     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1255-62     Citation Subset:  AIM; IM    
Division of Neuroradiology, University of Bern-Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland.
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MeSH Terms
Acute Disease
Aged, 80 and over
Arteriovenous Malformations / therapy
Craniocerebral Trauma / therapy
Embolization, Therapeutic / methods*
Epistaxis / therapy
Head / blood supply
Head and Neck Neoplasms / complications
Hemorrhage / therapy*
Iatrogenic Disease
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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